Whooping cough: symptoms and treatments

As whooping cough cases soar, we ask the experts which symptoms to look for, and how to prevent and treat this potentially deadly infection

The name whooping cough might conjure up images of Victorian England but the illness can strike thousands of patients during outbreaks, which occur every three to five years.
Surges in cases have occurred in 2012, 2016 and, most recently, 2024. While Britons are used to battling a week or so of sniffles and sore throats as a result of the common cold, flu or Covid, whooping cough can leave sufferers with a cough that persists for months on end.
The disease spreads quickly. It is more infectious than Covid and around as infectious as measles. It poses a particular worry for the elderly, people with a compromised immune system and babies. 
In short, staying at home in the early stages of symptoms to avoid passing it on, and checking your vaccines are up-to-date to avert serious illness, is key. But read on to find out how to spot it, treat it and reduce your risk.
Whooping cough, clinically known as pertussis after the bacteria that causes it (Bordetella pertussis bacterium), is a bacterial infection of the lungs and breathing tubes. It is also referred to as the 100-day cough because of how long it can take to recover.
More than 10,000 cases were confirmed in the first six months of 2024 in the UK. For comparison, around 9,000 were detected in a 2012 outbreak and 6,000 in a 2016 surge. Outside of these years, cases can range from around 50 to 3,500.
The most common symptoms of whooping cough are:
The illness progresses through three stages, the first being largely similar to a common cold with symptoms such as a runny nose, sore eyes and sneezing. 
After around a week or two, infected individuals begin to develop bouts of intense coughing which can last for several minutes and are typically worse at night. There may be an audible whoop or gasp for breath between coughs, though this is not always present, which can make it difficult to diagnose. Young children may turn blue or grey due to difficulty breathing while adults might become red in the face. 
Sufferers can then be left with a chronic cough which remains for several weeks. 
Dr Safia Debar, the executive health GP at Mayo Clinic Healthcare in London, recommends that anyone with a persistent cough lasting more than two weeks should see a doctor. “Particularly if you also have symptoms like lethargy and fever, or you’ve been in contact with somebody with whooping cough, then definitely seek medical attention,” she says. 
Treatment for whooping cough depends on how long a person has been infected and their age. Usually, the first step is a throat swab to check whether someone is infected with the Bordetella pertussis bacterium behind the infection and if so, prescribe antibiotics. 
“Antibiotics are given on a case by case basis,” Dr Debar says. “After the first three weeks, the infection tends to wane and sometimes if you’re just left with the chronic cough, it could be that you do not need antibiotics.”
Babies under six months and severe cases usually require hospitalisation.
For patients managing their symptoms at home, cough remedies aren’t usually effective but saline sprays can provide some relief, according to Dr Debar. “I love natural remedies, so ginger, turmeric, all things to strengthen immunity. 
“The coughing can be worse at night so you want the environment around you to be as moist as possible. So, use a humidifier, make sure the temperature is appropriate, and make sure you’re well hydrated. Maybe try an extra pillow if that helps.”
“It’s highly contagious and it’s spread via respiratory droplets,” says Dr Debar.
Without treatment, people are infectious from around six days after cold-like symptoms begin up to three weeks after their cough starts.
However, taking antibiotics within two or three weeks of starting to cough will reduce this infectious period. “Without treatment, people are infectious for three weeks, but with antibiotics, you’re not infectious after five days,” she says.
To prevent the spread of infection, people diagnosed with whooping cough are advised to stay at home and not to go to work, school or nursery until 48 hours after taking antibiotics or two weeks after their symptoms begin if they are not taking the medication.
Low immunisation rates can encourage the spread of whooping cough and make the infection more severe in unvaccinated individuals. 
The illness is most dangerous to newborn babies and infants. 
Most children under six months require hospitalisation due to the risks of brain swelling and convulsions. One to 3 per cent of those under three months die from the illness. 
“Babies are vulnerable because their immune systems haven’t fully developed,” explains Dr Dipender Gill, a medical doctor and researcher at Imperial College London. 
“It’s quite prevalent in school-aged children as well, so those who are 11 to 18 years old.” 
In teenagers and adults, serious cases of whooping cough can lead to pneumonia, fainting and even rib fractures due to the intensity of the coughing fits. 
However, Dr Gill says it tends to be the elderly and those with compromised immune systems who are among the most vulnerable, as they are less primed to fight off the infection.
The most effective preventable measure is to get vaccinated. Babies at eight, 12 and 16 weeks old are eligible for an immunisation on the NHS that protects against whooping cough (as well as other serious diseases such as diphtheria and polio). Additionally, a pre-school booster is offered at three years and four months.
Because whooping cough is so infectious, self-isolating if your doctor suspects that you have the illness is important to protect others. 
Experts are particularly keen to raise awareness that pregnant women are eligible for the whooping cough vaccine, ideally between 20 and 32 weeks. It is available through their GP and some antenatal services. However, fewer than six in 10 women typically take this offer up, down from a peak of nearly three-quarters in 2017.
“Newborns and babies in the first few months of life are more likely to get severe disease,” says Beate Kampmann, a professor of paediatric infection and immunity at the London School of Hygiene and Tropical Medicine. In the first six months of 2024, 10 children died from the illness.
“This is almost entirely preventable if the mother is vaccinated in pregnancy and her protective antibodies can then reach the baby through the placenta, and protect [it] until the baby gets its own vaccines,” she explains. 
Prof Kampmann recommends checking your own vaccine records in case you missed receiving this jab. It is also possible for concerned older individuals to receive a booster vaccine for whooping cough.
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